Percutaneous management of pulmonary metastases arising from colorectal cancer; a systematic review

2.50
Hdl Handle:
http://hdl.handle.net/11287/593983
Title:
Percutaneous management of pulmonary metastases arising from colorectal cancer; a systematic review
Authors:
Lyons, Nicholas J.; Pathak, Samir; Daniels, Ian R. ( 0000-0002-9114-0812 ) ; Spiers, Alexander; Smart, Neil J. ( 0000-0002-3043-8324 )
Abstract:
BACKGROUND: Radiofrequency ablation (RFA) is a well-established treatment modality for colorectal hepatic metastases, the success of which has prompted its use to treat other lesions such as colorectal pulmonary metastases (CRPM). Our aim was to perform a systematic review of the evidence and to assess the safety and effectiveness of ablative techniques in the management of CRPM. METHOD: A literature search was performed using PubMed, Embase, Cochrane Library, CINAHL and Google scholar databases to identify studies, which analysed ablative techniques and their effectiveness in the management of CRPM. The primary outcome measures were overall survival, local recurrence rates and disease free survival. Secondary outcome measures were complication (major/minor), chest drain insertion rates and follow up duration. RESULTS: Eight studies were included in the review with a total of 903 patients and all of which used RFA for ablation. Mortality from ablation was <1% with overall survival ranging from 31 to 67 months. 1, 3 and 5 year survival ranges of 84-95%, 35-72% and 20-54% respectively. Local progression following ablation ranged from 9 to 21%. Major complication rates were noted in 0.5%-8% of patients with minor complications ranging between 7% and 33%. 23% of patients required chest drain insertion post procedure. CONCLUSION: s: RFA is a safe and effective technique for the management of CRPM. However, in the absence of large randomised controlled trials it is unclear where RFA should sit in the treatment algorithm for patients with CRPM.
Citation:
Eur J Surg Oncol. 2015 Nov;41(11):1447-55.
Publisher:
Elsevier
Journal:
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Issue Date:
1-Nov-2015
URI:
http://hdl.handle.net/11287/593983
DOI:
10.1016/j.ejso.2015.07.018
PubMed ID:
26358568
Additional Links:
http://www.sciencedirect.com/science/article/pii/S0748798315006435
Type:
Journal Article; Systematic review
Language:
eng
ISSN:
1532-2157
Appears in Collections:
2015 RD&E publications; HeSRU publications

Full metadata record

DC FieldValue Language
dc.contributor.authorLyons, Nicholas J.en
dc.contributor.authorPathak, Samiren
dc.contributor.authorDaniels, Ian R.en
dc.contributor.authorSpiers, Alexanderen
dc.contributor.authorSmart, Neil J.en
dc.date.accessioned2016-01-19T12:38:15Zen
dc.date.available2016-01-19T12:38:15Zen
dc.date.issued2015-11-01en
dc.identifier.citationEur J Surg Oncol. 2015 Nov;41(11):1447-55.en
dc.identifier.issn1532-2157en
dc.identifier.pmid26358568en
dc.identifier.doi10.1016/j.ejso.2015.07.018en
dc.identifier.urihttp://hdl.handle.net/11287/593983en
dc.description.abstractBACKGROUND: Radiofrequency ablation (RFA) is a well-established treatment modality for colorectal hepatic metastases, the success of which has prompted its use to treat other lesions such as colorectal pulmonary metastases (CRPM). Our aim was to perform a systematic review of the evidence and to assess the safety and effectiveness of ablative techniques in the management of CRPM. METHOD: A literature search was performed using PubMed, Embase, Cochrane Library, CINAHL and Google scholar databases to identify studies, which analysed ablative techniques and their effectiveness in the management of CRPM. The primary outcome measures were overall survival, local recurrence rates and disease free survival. Secondary outcome measures were complication (major/minor), chest drain insertion rates and follow up duration. RESULTS: Eight studies were included in the review with a total of 903 patients and all of which used RFA for ablation. Mortality from ablation was <1% with overall survival ranging from 31 to 67 months. 1, 3 and 5 year survival ranges of 84-95%, 35-72% and 20-54% respectively. Local progression following ablation ranged from 9 to 21%. Major complication rates were noted in 0.5%-8% of patients with minor complications ranging between 7% and 33%. 23% of patients required chest drain insertion post procedure. CONCLUSION: s: RFA is a safe and effective technique for the management of CRPM. However, in the absence of large randomised controlled trials it is unclear where RFA should sit in the treatment algorithm for patients with CRPM.en
dc.language.isoengen
dc.publisherElsevieren
dc.relation.urlhttp://www.sciencedirect.com/science/article/pii/S0748798315006435en
dc.titlePercutaneous management of pulmonary metastases arising from colorectal cancer; a systematic reviewen
dc.typeJournal Articleen
dc.typeSystematic reviewen
dc.identifier.journalEuropean journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncologyen

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